Health IT Czar: Make EHRs More Doc-Friendly

by David Pittman David Pittman,Washington Correspondent, MedPage Today
January 23, 2014

WASHINGTON -- Physicians' effective use of electronic health records will play a critical role in the development of payment and delivery reforms, the country's new health information technology (IT) czar said in her first public comments.

The reliance on EHRs and the information they can provide physicians is why it's critical for federal regulations that address the development and use of EHRs be tailored to optimize their potential, Karen DeSalvo, MD, MPH, the new national coordinator for health information technology, said Thursday.

"The systems on the front line have to be usable so that doctors actually want to interact with the electronic health record, or [so that] nurses or others can access critical information that will eventually not just save money or improve the quality of care but save lives," DeSalvo said, speaking at the annual meeting of the Office of the National Coordinator (ONC) here.

An internist by training and most recently the health commissioner of New Orleans, DeSalvo helped move the outpatient clinic of the city's Charity Hospital to an electronic scheduling system as a young physician. She also worked at the Veterans Administration while it was adopting a system-wide EHR.

But the bulk of her health IT work came in the aftermath of Hurricane Katrina, which infamously flooded the city and destroyed many hospitals' paper records. DeSalvo helped rebuild the city's health information infrastructure, which was based on electronic records; that allowed for a transformation of payment and delivery models, she said.

"When asked to be a part of ONC's leadership, I said 'Absolutely yes' because this is a critical period where we need to do in this nation to reform the healthcare delivery system," DeSalvo said. "We are making strides in expanding coverage and getting everybody in the tent. Our challenge now is to see that when everybody is in the tent that the care is as effective and efficient and safe as possible."

She also previously served as president of the Louisiana Health Care Quality Forum, which is the state's lead organization for its health information exchange and regional extension center grants.

"I'm more than a cheerleader for health information technology," DeSalvo said. "I am actively engaged in the space as a doctor, as a leader, and a public health official."

Despite her short time on the job, others still have plenty of advice for DeSalvo.

"Some of the 2014 certification test procedures have negatively impacted the healthcare IT industry by being overly prescriptive and by requiring functionality/workflows that are unlikely to be used in the real world," Halamka, who is also co-chair of the Health IT Standards Committee that makes recommendations to ONC, wrote on his blog.

He said ONC could also rethink its various timelines for programs such as ICD-10 and "meaningful use," so they don't coincide so much and wreak havoc.

In other news on Thursday at the ONC annual meeting, the Department of Health and Human Services and the U.K. Secretary of State for Health signed a memorandum of understanding allowing the countries to share health IT tools.

The agreement will, for example, allow collaboration on quality indicators, adopting EHRs, and other areas.